Role Of Diabetes Educator Research Articles

Using Motivational Interviewing to Overcome Psychological Insulin Resistance

Psychological insulin resistance can delay insulin therapy when initiating insulin therapy in patients with type 2 diabetes mellitus. The role of diabetes educator is important in reducing patients’ psychological insulin resistance through various approach. Motivational interviewing not only promotes diabetes selfmanagement, but also can help to overcome psychological insulin resistance. Diabetes educators can help smooth the transition to insulin in diabetic patients using motivational interviewing. In this article, I introduce basic counseling skills of motivational interviewing addressing psychological insulin resistance.

668-P: Experiencing a New Role for the Diabetes Educators Recruiting for Longitudinal Studies, Kuwaiti Experience

Background: Kuwait is the second highest country in the incidence of T1D globally. Familial study of this disease may disclose certain causative agents responsible for passing the disease through families. The recruitment of T1D patients and their family members to participate in a Kuwaiti autoimmune diabetes (KADS) Study was challenging. It is a longitudinal study, it required taking blood samples every 6 months for 3 years duration for all family members of a person with diabetes. It is important to note that, in Kuwait, convincing families to participate in researches were an extremely difficult task which needs a highly skilled personal to persuade family participations. Aim: This abstract aimed to examine different recruitment approaches which were used and highlights the role of diabetes educators (DE) in the recruitment process. Method: Three recruitment approaches were examined.1-Physician-approach; recruitment took place through their physicians follow up visit.2-Research coordinator (RC) approach recruitment took place in the clinic area. While patient is waiting for his medical appointment the research coordinator offers participating in the research.3-DE approach Recruitment took place through their educator follow up visit. Results: Physicians were able to recruit 22 participants, but none of them completed the process of participation. While the RC could not recruit any participants. However, the DEs were able to recruit 274 participants. Conclusion: Although the Kuwaiti families are generally obedient to their doctors, the physician were not able to recruit only few participants for this study. In contrast, the prolonged pre-established good relationship between the patient, family and the DE resulted in mutual trust and facilitated the process of recruitment. Hence, more subjects were recruited compare to the physician and the RC approaches. Thus, the DE approach was proved to be a successful approach to recruit people for researches. Disclosure Z. Rahme: None. N.A. Taha: None. N. Mesbah: None.

Certified Diabetes Educator: An Important Aid in Improving Patient Care in Diabetes

AbstractDiabetes mellitus is a chronic disease in which education plays a vital part. However, in India that is overburdened with diabetes has short of diabetes educators. Care for diabetes is limited by the adverse physician-to-patient ratio and lack of trained paramedical personnel. The following review focuses on role of diabetes educators in diabetes care and their current status in India.

647-P: Role of Diabetes Educators in Providing Insulin Pump Training for School Nurses and School Physicians—Kuwait Experience

Objective: to investigate the impact of basic insulin pump training for school nurses and physicians on knowledge and confidence in caring for type1 diabetes[T1D] students using insulin pump therapy [IPT]. Methods: In groups of 15 healthcare professionals, a pediatric diabetologist and 3 diabetes educators (who are certified pump trainers) provided basic pump training for 137 healthcare providers, who were novice to IPT. For a duration of 4 hours, the training included 2 interactive lectures about IPT, management protocols of hyperglycemia, hypoglycemia and ketosis, followed by hands-on insulin pump workshop. Pre and post knowledge assessment about IPT management was performed using a 10-item knowledge questionnaire. Pre and post confidence level were assessed with a 9-item questionnaire using Likert’s scale T. Results: 62 school nurses (7males) mean age 41.5 ± 11.7, with school experience of 8.8 ± 9.1 y and 75 school physicians (13 males), mean age 36.25 ± 6.2, with school experience 3.4 ± 1.5 y; attended the mentioned training. Pre and post knowledge assessment and confidence level scores were compared using Pearson’s correlations. Significant improvement in knowledge were found for both schools' physicians (r=0.007) and nurses (r=0.01). Additionally, significant improvement in confidence in caring for T1D students on insulin pump were found for both school physicians (p-value=0.047) and school nurses (p-value=0.018). Conclusion: Pre-assessment showed the lack of knowledge and low confidence of school healthcare professionals about IPT. Significant improvement in knowledge and confidence in caring for T1D students who are on IPT resulted from the delivery of these workshops, which proved the effective role of diabetes educators to pump the knowledge and skills and enhanced their confidence in providing essential management for students at schools. Disclosure Z. Rahme: None. N. Mesbah: None. F. Aljaser: None. E. Saad: None. N.A. Taha: None.

New Pharmacist Role in Diabetes Education in Sri Lanka: A Cross-Sectional Descriptive Randomized Step-Up Study

Complications of T2DM due to poor control lead to early disability which is not only debilitating to those affected, but also a burden on their communities, healthcare services and the socioeconomic status of the country.

The Role of Diabetes Educators in Reduction the Risk of Hypoglycemia in Type 1 Patients during Fasting Ramadan

Background/Objectives: Fasting Ramadan for type 1 patients could be a challenging for both patients and physicians due to complications such as hypoglycemia, so in this study we choice to introduce glucose sensor and intensify the role of diabetes educator follow-up for type 1 patients who already on pump and willing to fast Ramadan for the first time. Design and Methods: This is a pilot prospective cohort study. Total of 6 patients (4 females and 2 males) with type 1 diabetes were recruited. Their mean age is (21.8+/-2.2) years, diabetes duration(11.1+/-2.3) years, mean duration on insulin pump is (4+/-1.6)years. Insulin basal rates of infusion were reduced 5-10% during fasting hours and increased between 5-10% after breaking fast. Weekly follow-up visits during Ramadan took place as well a daily follow-up by phone with the educator. Patients were asked to wear glucose sensor for entire days of fasting to detect hypoglycemia. Results: An (28.8+/- 8.6) units for 24 hours of basal insulin were set before fasting, and (26.8+/- 7.5) units for 24 hours of basal insulin were required for fasting Ramadan, and from that (15.1+/-4.3) units was basal insulin for total hours of fasting(14 hours), part of it explained by food habitus and lack of activity during Ramadan. An average of blood glucose was (11.1+/-2.1) mmol/l an hour before futoor, (9.7+/-3.8) mmol/l two hours after futoor, and (12.5+/- 3.4) mmol/l at suhoor. On the first week, four hypoglycemic episodes (BG less than 3.9 mmol/l), daily follow-up by diabetes educator, pop up visit in educator office and weekly visit to physician and educator office reduce the episode of hypoglycemia by the 2nd week till the 4th week of Ramadan. Conclusions: The use of glucose sensor together with adjustment of basal insulin wasn’t enough to minimzing the fear of fasting Ramadan but with role of diabetes educator reduce the risk of further hypoglycemia episode. Disclosure S. Mourad: None.

Investigation and analysis of the work status of diabetes specialist nurse

Objective To investigate the work carrying out and learning status of diabetes specialist nurse in training program, in order to optimize diabetes specialist nurse training program and provide evidence for its improvement. Methods The study used E-mail to investigate the nurses′ existing work plant-forms and conditions, diabetes specialist nursing practice, continuing education and improvement by diabetes specialist nurses training scale after the diabetes specialist nurse training. Results A total of 124 diabetes specialist nurses were questioned for the survey, and 80.65% of them were engaged in diabetes health education or diabetes nursing care, and 8.06% of them left from the diabetes care ward because of promotion or redeployment. The biggest problem of engaged in the work of diabetes specialist nursing was lack of diabetes specialist nurse post occupying 48.39%, and 77.42% trained nurses had improved the diabetes nursing care mode and achieved good results. Meanwhile, 20.97% trained nurses′ hospital opened a diabetes care clinic, and 37.1% trained nurses attended the diabetes professional academic exchange. Conclusions The diabetes health education and management were carried out better after diabetes specialist nurse training program compared without training. The training and qualifying of diabetes specialist can improve the status and role of diabetes educator, so as to contribute to the development of diabetes care, education and management. Key words: Diabetes specialist nurse; Training base; Investigation and analysis

Psychosocial management of diabetes: Role of diabetes educator

AbstractDespite of the evident need for psychosocial competence and sensitivity in diabetes care professionals, this field remains sub optimally described in both International Diabetes Federation/American Diabetes Association and National Diabetes Educator Program curricula. This unfortunate omission is formidable challenge for diabetes care and poses an urgent need to amend existing curricula for training of diabetes educators (DEs). Diabetes education programs have exhaustively described the hard skills and also mention the importance of behavioral change, communication skills and cultural competence, yet soft skills of addressing psychosocial concerns have been given a Cinderella treatment. Diabetes educator (DE) has to be professional, personal and like a family member to patient forming a valuable link between treating clinician and the people with diabetes (PwD). Looking at the gap and the future aspects, a universal approach of sensitization which includes both the beneficiary and policy makers has to be adopted. Better description and importance of psychosocial aspects of diabetes have to be included in the curricula for DE training.

New Onset Diabetes after Transplantation [NODAT] Risks Factors Outcome and Possible Role of Diabetes Educators

New-onset diabetes after transplantation [NODAT] is well known complication after organ transplantation especially after solid organ transplantation, bone marrow and hematopoietic stem cells. The incidence of NODAT was observed to be different over post-transplant intervals. It has many risk factors and adverse clinical outcomes include allograft dysfunction, infections, cardiovascular morbidities, and increased mortalities among renal transplant patients. Its management should start before transplantation with special stress on risk factors, modulation of immunosuppressive agents and role of diabetes education before during and after transplantation.

Role of Diabetes Educators and Effectiveness of Diabetes Education

Role of Diabetes Educators and Effectiveness of Diabetes Education

Managing Diabetes From First Diagnosis

A review of the pathophysiologic features of early type 2 diabetes mellitus, the benefits of early glycemic control, the concerns of patients that may influence treatment adherence, and how the use of newer treatment options are addressed. Given the multifactorial nature of diabetes pathophysiology, early combination therapy incorporating agents with different mechanisms of action is advocated. Medication side effects and risks influence patients' treatment choices. These concerns include hypoglycemia, weight gain, and fears of treatment failure. With the increasing complexity of therapy regimens for diabetes, the role of diabetes educators includes recommending therapy, counseling about adverse effects, monitoring for contraindications, identifying therapeutic duplication, as well as discussion of new agents to optimize patient outcomes. A case study is used to describe the process of choosing well-tolerated therapies at first diagnosis.

Prediabetes: a focus on the role of diabetes education in prevention of type 2 diabetes

Awareness of the seriousness and magnitude of the diabetes epidemic has heightened, resulting in increasing emphasis being placed on prevention. In the last decade, several major institutions have developed guidelines for prevention measures. The World Health Organization (WHO) developed the Action Plan on Prevention and Control of Non-Communicable Diseases in 2008, 1 and a global strategy on Diet, Physical Activity and Health (DPAS) in 2004. 2 These provide a framework within which governments can develop policies that promote healthy eating and increased physical activity. The International Diabetes Federation (IDF) produced a consensus paper in 2007 3 which challenged governments in both the developed and the developing world to create national diabetes prevention plans. These plans should aim to identify those at high risk of diabetes, and should recommend strategies using lifestyle and environmental changes to prevent progression of the condition. 3 Sixty per cent of all deaths worldwide are attributed to noncommunicable diseases such as diabetes, heart disease and cancer. 1 Unhealthy lifestyles such as poor diet, lack of physical activity and obesity are considered to be the main causative factors in these conditions.

The Constantly Changing Role of Diabetes Educators

D iabetes educators are health care professionals qualified to work and help people with and at risk for diabetes. The role of diabetes educators is dynamic and shaped by the environment in which they practice and by developments in research and technology. Signs indicate that health care is moving toward a focus on primary care and wellness. We have heard this before, but I believe this time the notion of prevention and wellness will come true. What’s in it for diabetes educators? Plenty! Primary care, access, and wellness have long been the work of diabetes educators. Thinking back over the years, diabetes educators have delivered care to those who had trouble accessing it or affording it. Our current health care system is focused on costly acute and tertiary care. Could it be that we will now move, however slowly, toward a model where we intervene in people’s lives early enough to prevent some of the major diabetes-related complications that plague our population and cost us a fortune? And will such preventive care be valued and reimbursed at a level reasonable enough to support educators? Hopefully. Either way, diabetes educators will be in the forefront. The American Association of Diabetes Educators (AADE) is diligent in preparing future educators at all levels. It is an association of health care professionals dedicated to integrating successful management as a key outcome in the care of people with diabetes. AADE is key to your professional success—providing opportunities and resources to advance skills and career goals while offering a vibrant, supportive network. AADE has made it a priority to create materials and resources that will strengthen practice, produce products and programs that support members, and embrace initiatives that promote change. As diabetes educators, we have an opportunity to set the pace for the future by using the talents and skills we’ve learned over the years. As we look to the future, there is no doubt that change is coming, and so is a continuing bright future for diabetes educators. It’s not enough to wait for the change; we should be driving it. The future might not look the same, but the talents, skills, and values shaping it will be. AADE is committed to work hard and prepare educators for the variety of roles they will play moving forward.

Practice nurses’ role and knowledge about diabetes management within rural and remote Australian general practices

AbstractBackground: The increasing prevalence of diabetes and obesity represents a significant disease burden in Australia. Practice nurses (PNs) play an important role in diabetes education and management.Aim: To explore PNs’ roles, knowledge and beliefs about diabetes education and management in rural and remote general practice in Australia.Method: Exploratory study undertaken in three phases: 1) Pilot study to test the performance of the questionnaire; 2) One-shot cross-sectional survey using self-complete questionnaires; 3) Individual interviews.Results: Ten PNs completed the pilot test; the draft questionnaire was deemed appropriate to the study purpose. Then, 65 questionnaires were distributed to PNs and 21 responded. Fourteen respondents had worked in the role <5 years, and most PNs attended diabetes education programmes in their workplace. A minority (40%) used diabetes management guidelines regularly. Most knew obesity to be the most common risk factor for diabetes but only 50% knew that glycosy...

The Australian diabetes educators’ skills and readiness for the tsunami of diabetes in the 21st century

Objective: The objective of the study was to identify the knowledge, skills and practices of diabetes educators in relation to teaching and learning. Design: Quantitative and qualitative analysis of an online survey. Setting: Diabetes educators across Australia. Subjects: A convenience sample self‑selected from the Australian Diabetes Educators Association (ADEA) data base.Main Outcome Measures: Attributes and barriers to effective teaching and learning. Results: The survey response rate was 16.2% (n=212) of the 1306 ADEA members. 79% were aged &gt;40years and 10% were &gt;60years; 93% were female; and 34% worked in the role of diabetes educator full‑time. ADEA respondents spent 50% of their day on client education; 20% on administration; and 30% equally distributed between research, quality improvement, staff education and other duties. Barriers to effective teaching and learning were a lack of time, resources and issues associated with bedside teaching. Text responses indicated the desire to provide individualised, culturally, age and gender specific education. The majority of respondents (range 99.1%‑95.5%, p=0.000) reported that providing education that allowed informed choices; helping clients learn from their choices and decisions; collaboratively writing goals and objectives; developing specific and tailored education programmes; teaching in a way that matched the clients’ experiences; using interpreters; and involving families or significant others, were important. Conclusion: Respondents were aware of the teaching and learning needs of their clients. However strategies to address barriers to effective teaching and learning and the need to maintain advanced skills and knowledge in the context of continuously changing practice and client demographics need to be considered.

The Role of Diabetes Educators in the Medical Home

From the 1960s to 2000, there was very little improvement in diabetes care in the United States. However, since 2000, there has been substantial improvement. Median A1C reached 7.18% nationally in 2005. In adults with diabetes, median LDL cholesterol is now ~ 85 mg/dl, and median blood pressure is ~ 130/78 mm Hg.1,2 Endocrinologists and diabetes educators have led the charge, but most of the diabetes care in the United States is provided by primary care physicians, and the national improvements reflect better diabetes care in primary care practices in recent years.3 Yet primary care is currently in crisis. Increased patient demand, a reduced number of providers, and the demands of working in an information-rich environment leave too little time to meet patient needs. Unaddressed societal health problems that include obesity and unhealthy lifestyles may lead to future decline in the overall health of the American population.4 The growing shortage of primary care physicians, in the face of the growing number of Americans with chronic diseases, mandates new approaches to care delivery that expand access through team models within primary care settings—perhaps most importantly for those with diabetes and related conditions. One of the most important clinical revolutions in diabetes care in the past 10 years is the realization that ~ 70% of those with diabetes die of heart attacks or strokes.5 Moreover, it is not only elevated A1C that drives these catastrophic events; it is also elevated blood pressure, elevated LDL cholesterol, and tobacco use. National quality measures for diabetes have now evolved to what is known as a “comprehensive measure” widely endorsed by advocacy groups, health care delivery organizations, and payers. The 2008 diabetes comprehensive measure requires that a given patient's diabetes be counted as “controlled” only if the patient reaches goals …

21st Annual Isle of Wight Conference on Diabetes – Part 2

21st Annual Isle of Wight Conference on Diabetes – Part 2

Why Should I Take One More Exam? From Larvae to Butterflies

Diabetes educators came into the health professional world just a few decades ago and have developed from larvae into mature and intricate butterflies within the diabetes community. Marking the 25th year of my diabetes health care career recently provided me an opportunity to reminisce about my professional life and the evolution of my profession. The role of diabetes educator was created to meet the specific need to teach and support people living with diabetes. In the years since, the role has expanded to define independently functioning practitioners who are integral players on the diabetes care team. In the mid-1970s, “diabetes educator” was a fairly new title for a fairly new specialty. My mentor, Dr. Diana Guthrie, became one of the founding 200 members of the American Association of Diabetes Educators (AADE) in 1973. She served on the AADE national board of directors, and, in 1979, she was recognized with the American Diabetes Association Outstanding Educator in Diabetes Award. I saw her as the model for professional expertise and development in the field. The certified diabetes educator (CDE) credential became available in 1986, and we all took the exam. This credential verified to the public that we had expertise in the arena of diabetes education. It did not, alas, guarantee any reimbursement for our work. Still, it has since become the gold standard for professionalism in diabetes education and is recognized by employers as a prerequisite for hiring in the field. Even …

Nursing, food service, and the child with diabetes.

The safety and well-being of children while they are at school or day care is a major concern in our society. It is therefore important that the professionals who are entrusted with the care of young people possess the knowledge and skills necessary to provide a safe and caring environment for all children, including those with chronic disorders such as diabetes. Each day 35 children in the United States are diagnosed with diabetes mellitus. To make their school experiences positive, it is imperative that school employees be aware of the potential challenges associated with diabetes and how to meet these challenges successfully. This article discusses the role of the school nurse in forming an interdisciplinary team to work with a child with diabetes. It addresses the school nurse's role in diabetes education of food service personnel in the school. Confidentiality issues are also addressed.

Diabetes self-management education programs in the Veterans Health Administration.

The role of diabetes educators is likely to evolve and expand due to the development of chronic disease management programs that are based on a multidisciplinary approach of healthcare providers. In addition to providing self-management education and training to more patients with diabetes, educators will most likely need to expand their services to include case management and quality management of process and health outcomes.